Racial Background Affects Your Risk for Alcoholic Liver Disease

New research from a team of American scientists points to substantially varying levels of risk for alcoholic liver disease in people with different racial/ethnic backgrounds.

Any person who repeatedly drinks alcohol in heavy amounts can develop at least one of a group of moderate, serious or severe physical conditions known collectively as alcoholic liver disease. In a study published in February 2015 in the journal Alcoholism: Clinical & Experimental Research, researchers from the University of California Davis examined the factors associated with these conditions in people of Caucasian American, African American or Hispanic descent. The researchers concluded that the factors connected to alcoholic liver disease in these three racial/ethnic groups vary considerably.

Alcoholic Liver Disease

The first aspect of alcoholic liver disease is a condition called alcoholic fatty liver disease, which affects more than 90 percent of all people who maintain a long-term pattern of repeated, excessive alcohol intake. People with this condition experience an abnormal accumulation of fat inside their livers; this fat alters the normal placement of the liver’s tissue cells and increases the organ’s size. The second aspect of alcoholic liver disease, alcoholic hepatitis, affects roughly one-10th to one-third of all people who drink excessively over prolonged periods of time. The hallmark of this condition is damage-inducing inflammation of liver tissue that may ultimately produce liver cell death. The third aspect of alcoholic liver disease, alcoholic cirrhosis, affects roughly one-10th to one-fifth of all people with prolonged histories of recurrently excessive drinking (including some individuals with alcoholic hepatitis). This condition destroys liver tissue and leaves permanent liver scarring in its wake.

There is a general hierarchy of severity to alcoholic liver disease. People with alcoholic fatty liver disease have a potentially reversible condition that can improve with treatment. People with alcoholic hepatitis have a condition that’s reversible in mild cases but potentially fatal in advanced cases. Alcoholic cirrhosis can also kill on its own or contribute to the onset of potentially fatal liver cancer. As a rule, alcoholic liver disease first appears in individuals in their third or fourth decade of life who meet the criteria used to identify cases of alcohol dependence (alcoholism). Severe forms of the disease usually appear in people who are at least in their 50s.

Alcohol and Racial/Ethnic Background

A federal agency called the Substance Abuse and Mental Health Services Administration does a racial/ethnic breakdown of nationwide alcohol consumption each year as part of a project called the National Survey on Drug Use and Health (NSDUH). According to the latest NSDUH figures (which cover the year 2013), Americans with Caucasian ancestry consume alcohol more often than any other racial/ethnic segment of the population. Caucasian Americans also have a relatively high rate of involvement in binge drinking and heavy drinking, two particularly dangerous patterns of alcohol intake. In descending order, the next three racial/ethnic groups with the highest rate of alcohol consumption are people with a mixed racial/ethnic background, African Americans and Hispanics. Along with Caucasians, groups with relatively high rates of involvement in heavy drinking and/or binge drinking include Hispanics, American Indian/Alaska Natives, Native Hawaiian/Other Pacific Islanders, African Americans and people with mixed racial/ethnic heritage.

Relative Risks for Alcoholic Liver Disease

In the study published in Alcoholism: Clinical & Experimental Research, the UC Davis researchers used information collected from 791 adults to help identify the racial/ethnic factors associated with risks for developing alcoholic liver disease. Most of these adults (507) had alcoholic cirrhosis, while the remainder had alcoholic hepatitis (154 individuals) or alcoholic fatty liver disease (130 individuals).

The researchers concluded that the biggest racial/ethnic disparity in risks for alcoholic liver disease appears in people of Hispanic descent who drink heavily for long periods of time. Compared to Caucasian Americans, these individuals typically develop all three forms of the disease anywhere from four to 10 years earlier in life. People of Hispanic descent with alcoholic liver disease also have higher obesity rates than their Caucasian counterparts, as well as a higher level of exposure to diabetes. People of African American descent have an unusual tendency to develop a hepatitis C infection in combination with alcoholic hepatitis. Compared to African Americans, both Caucasian Americans and Hispanics have increased and roughly equal chances of developing advanced cases of alcoholic hepatitis. Overall, the study’s authors identify racial/ethnic background as a major but varying deciding factor in the odds that any heavy drinker will develop moderate or severe alcoholic liver disease.

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